Alcohol and illicit drug use among young people living with HIV compared to their uninfected peers from the Kenyan coast: prevalence and risk indicators

Abstract

Background In sub-Saharan Africa, there is paucity of research on substance use patterns among young people living with HIV (YLWH). To address the gap, we sought to: i) determine the prevalence of substance use, specifically alcohol and illicit drug use, among YLWH compared to their HIV-uninfected peers; ii) investigate the independent association between young people’s HIV infection status and substance use; iii) investigate the risk indicators for substance use among these young people. Methods Between November 2018 and September 2019, a cross-sectional study was conducted at the Kenyan coast recruiting 819 young people aged 18–24 years (407 HIV-positive). Alcohol and drug use disorders identification tests (AUDIT and DUDIT) were administered via audio computer-assisted self-interview alongside other measures. Logistic regression was used to determine substance use risk indicators. Results The point prevalence of current substance use was significantly lower among YLWH than HIV-uninfected youths: current alcohol use, 13% vs. 24%, p < 0.01; current illicit drug use, 7% vs. 15%, p < 0.01; current alcohol and illicit drug use comorbidity, 4 vs. 11%, p < 0.01. Past-year prevalence estimates for hazardous substance use were generally low among young people in this setting (< 10%) with no significant group differences observed. Being HIV-positive independently predicted lower odds of current substance use, but not hazardous substance use. There was overlap of some risk indicators for current substance use between young people with and without HIV including male sex, khat use and an experience of multiple negative life events, but risk indicators unique to either group were also identified. Among YLWH, none of the HIV-related factors was significantly associated with current substance use. Conclusions At the Kenyan coast, substance use is a reality among young people. The frequency of use generally appears to be low among YLWH compared to the HIV-uninfected peers. Substance use prevention initiatives targeting young people, regardless of HIV infection status, are warranted in this setting to avert their potential risk for developing substance use disorders, including dependence. The multifaceted intrapersonal and interpersonal factors that place young people at risk of substance use need to be addressed as part of the substance use awareness and prevention initiatives.

Alcohol use, suicidality and virologic non‐suppression among young adults with perinatally acquired HIV in Thailand: a cross‐sectional study

“…A 2014 study in Thailand, Malaysia and Vietnam reported that 32% of adolescents at the median age of 14.5 years drank alcohol [27]. The frequency and severity of alcohol use among Thai YA-PHIV in this study was higher than in a Kenyan study in adolescents and young adults with HIV who were at a similar median age of 21 years [28]. They reported alcohol use among 13%, with 5.4% drinking at harmful and 2.0% at dependent levels.…”

Psychoactive Substance Use Disorder in HIV-Infected Adolescents in Botswana: A Comparison Between the Congenitally Infected and Behaviorally Infected Adolescents

“… 23 However, it was similar to the 13% (95% CI: 10.1-16.7) reported among older adolescents and youths in the other study conducted in Kenya. 22 This observation is possible because the present study comprised older adolescents, as in the latter study, compared to the Ugandan study, which predominantly included younger adolescents. The present study may also reflect the high rate of alcohol consumption in Botswana, with adult per capita alcohol consumption (APC) of 8.4 L of pure alcohol per year, which was higher than the African region average of 6.0 L, and the global average of 6.2 L. 24 Botswana was rated as the third highest in the Southern Africa region, after South Africa and Namibia, and a hazardous drinking rate of 22% was recently reported among adolescents.…”

“…The male gender was observed to predict SUD as in several other studies, 34 including those among the adults, 34 seronegative, 25,35 and seropositive adolescents, regardless of the MOI. 19,22,23 After controlling for the effect of the MOI, male gender remained significantly associated with SUD. Likewise, older adolescents were more likely to have SUD than the younger ones, as documented among both infected 19,22 and noninfected populations, 1 but this association paled when the MOI was controlled for.…”

“…The alcohol and drug use pattern in the ALWHIV who participated in the current study followed the documented trend among seropositive adolescents. 22 , 23 Alcohol was the most used, with a current rate of 15.8%. Compared with the two most recent studies from sub-Saharan Africa, 22 , 23 the rate in this study was higher than that conducted among relatively younger adolescents in Uganda, which reported a rate of 4.3%.…”

“… 22 , 23 Alcohol was the most used, with a current rate of 15.8%. Compared with the two most recent studies from sub-Saharan Africa, 22 , 23 the rate in this study was higher than that conducted among relatively younger adolescents in Uganda, which reported a rate of 4.3%. 23 However, it was similar to the 13% (95% CI: 10.1-16.7) reported among older adolescents and youths in the other study conducted in Kenya.…”